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Consensus guidelines for diagnosis and management of anemia in epidermolysis bullosa.

Orphanet journal of rare diseases
January 1, 1970
Carmen Liy-Wong et al. (12 authors)
Journal ArticleReviewResearch Support, N.I.H., ExtramuralResearch Support, Non-U.S. Gov'tHuman Study
Study Details

Study Goal

The researchers aimed to establish consensus guidelines for the diagnosis and management of anemia in patients with epidermolysis bullosa (EB), including the use of iron supplementation.

Results Summary

The study generated 26 consensus statements, resulting in 6 recommendations for managing anemia in EB patients. Iron supplementation (oral or infusion) was recommended based on anemia severity, with dietary measures advised for all patients.

Population

Patients with moderate to severe forms of epidermolysis bullosa (EB).

Effective Dosage

Not specified (oral iron for mild anemia; iron infusion for moderate to severe anemia).

Duration

Not specified.

Interactions

None mentioned.

Extracted Claims (5)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Dietary measures
decrease
anemia
all EB patients
-
should be offered as part of management
#1
oral iron supplementation
decrease
mild anemia
EB patients
-
should be used
#2
iron infusion
decrease
moderate to severe anemia
EB patients
-
is reserved for
#3
transfusion
increase
Hb
adults
< 80 g/L (8 g/dL)
should be administered
#4
transfusion
increase
Hb
children
< 60 g/L (6 g/dL)
should be administered
#5
Abstract

BACKGROUND: Anemia is a common complication of severe forms of epidermolysis bullosa (EB). To date, there are no guidelines outlining best clinical practices to manage anemia in the EB population. The objective of this manuscript is to present the first consensus guidelines for the diagnosis and management of anemia in EB. RESULTS: Due to the lack of high-quality evidence, a consensus methodology was followed. An initial survey exploring patient preferences, concerns and symptoms related to anemia was sent to EB patients and their family members. A second survey was distributed to EB experts and focused on screening, diagnosis, monitoring and management of anemia in the different types of EB. Information from these surveys was collated and used by the panel to generate 26 consensus statements. Consensus statements were sent to healthcare providers that care for EB patients through EB-Clinet. Statements that received more than 70% approval (completely agree/agree) were adopted. CONCLUSIONS: The end result was a series of 6 recommendations which include 20 statements that will help guide management of anemia in EB patients. In patients with moderate to severe forms of EB, the minimum desirable level of Hb is 100 g/L. Treatment should be individualized. Dietary measures should be offered as part of management of anemia in all EB patients, oral iron supplementation should be used for mild anemia; while iron infusion is reserved for moderate to severe anemia, if Hb levels of > 80-100 g/L (8-10 g/dL) and symptomatic; and transfusion should be administered if Hb is < 80 g/L (8 g/dL) in adults and < 60 g/L (6 g/dL) in children.

Medical Subject Headings (MeSH)
ChildAdultHumansEpidermolysis BullosaAnemiaConsensusHealth PersonnelIronEpidermolysis Bullosa Dystrophica
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality65/10
Citation Metrics
Total Citations7
Citations/Year3.5
Relative Citation Ratio2.50
NIH Percentile80.7%
Research Impact Scores
APT Score0.75
Weight Score1.43
Normalized Score0.63
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